The ShiftShapers Podcast David Saltzman

The focus of this week's episode is on how modern healthcare system innovations utilize throwback TPA. Bob McCollins, vice president of sales at Edison Health Solutions, explains what’s happening in the TPA industry today and how a throwback TPA can help combine all the fantastic solutions out there to provide top-notch services.

What You’ll Learn From This Episode:
2:34 What throwback TPA means and how it works with current healthcare systems.4:35 Keeping all of the various solutions together for the benefit of clients and potential clients.7:57 TPAs need to be adaptable or focused on a single path in order to provide best-in-class services.11:10 Changes to offerings and support in reference-based pricing.14:48 Tasks they outsource to third parties.16:39 Factors affecting claims' automatic adjudication.20:35 TPA in the coming years.
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In this week’s episode, Ted Mills, CEO of Perigon Health 360, discusses his best practices for boosting compliance among patients. He explains the consequences of reduced compliance from both a health and financial perspective. He also breaks down Perigon’s “unit dose verification” process and how monitoring compliance elevates the role of the pharmacist and the care plan. Finally, Ted talks about the importance of maximizing patient engagement.
What You’ll Learn From This Episode:
1:30 Defining “compliance”.3:06 The problem in not taking one’s medication in terms of health as well as the dollar value of plans.9:00 Why complications that come with adding a second medication contribute to decreased compliance.12:19 Defining “unit dose verification”.13:06 Useful technologies on the market to consider, and what’s upcoming.16:01 Reducing friction to improve compliance.18:46 Developing a strong relationship with patients in a post-COVID world.Enjoy The Show?
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In this week's episode, Keri Cooper, licensed clinical social worker and author of the book Mental Health Uncensored, discusses the teen mental health crisis that has been making headlines. She emphasizes the importance of parental involvement and shares some tried and true methods that she's used in her own practice for the past 20 years.

What You'll Learn From This Episode:
1:46 How Keri became involved in the mental health field.3:30 Five simple things that can have a huge impact on your mental health.4:51 How gadgets and social media contribute to mental health problems.7:05 Educating children about the dangers of excessive use of mobile devices and social media.12:38 How parents handle peer pressure and keep their children's best interests in mind.14:20 Learning to say no and dealing with your children’s disappointment.16:10 Using mental health as a crutch.17:15 What parents can do to help their children avoid suicide.
Quotes:
3:11 “If we, as our own being, are not taking care of our physical body, we can't have optimal mental health.”
4:08 "Sleep, I think is crucial. That's how your body really restores itself, and if we're not on top of that and setting up good sleep habits for these kids from an early age, I think we're missing a big piece of this.”
5:12 “You have to get the devices out of the bedroom. There is nothing good happening on your child's device at three in the morning.”
9:42 “As teenagers, you want to fit into a social circle—this is very normal. So, of course, you're going to compare, it's really the hardest part of life for that, but to give them the perspective that you're not in competition with anybody.”
12:51 “Parents really need to start thinking, is this what I want? Is this what's best for my family? Or am I just going along with what everyone else does?”
17:00 “Yes, you have anxiety. And yes, that's real. But we need to be able to learn the skills to work through it, and to be able to enjoy our life and not just throw our hands up and say I can't.”
3:11 “If we, as our own being, are not taking care of our physical body, we can't have optimal mental health.”
4:08 "Sleep, I think, is crucial. That's how your body really restores itself, and if we're not on top of that and setting up good sleep habits for these kids from an early age, I think we're missing a big piece of this.”
5:12 “You have to get the devices out of the bedroom. There is nothing good happening on your child's device at three in the morning.”
9:42 “As teenagers, you want to fit into a social circle—this is very normal. So, of course, you're going to compare, it's really the hardest part of life for that, but to give them the perspective that you're not in competition with anybody.”
12:51 “Parents really need to start thinking, is this what I want? Is this what's best for my family? Or am I just going along with what everyone else does?”
17:00 “Yes, you have anxiety. And yes, that's real. But we need to be able to learn the skills to work through it, and to be able to enjoy our life and not just throw our hands up and say I can't.”

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Don't miss an episode, subscribe via iTunes, Stitcher or RSS.Leave us a review in iTunes (here's how)Join the conversation by leaving a comment below!

This week's episode focuses on CPESN USA's clinically integrated network of community pharmacies. Troy Trygstad, Executive Director of CPESN USA, explains how we can leverage these existing relationships to deliver lower-cost but higher-quality and higher patient satisfaction.
What You’ll Learn From This Episode:
1:32 A chain without actually being a chain.2:30 Problems that CPESN is attempting to mediate6:31 The value proposition that locally owned pharmacies must have in 2022.13:11 Using existing strong and trusted local relationships to develop a common way of expressing value.18:28 The trajectory of pharmacy practice—going beyond dispensing.Quotes:
2:21 “At the end of the day, our job is to bring together the value propositions of mom-and-pop pharmacies out there and really act like a chain without being a chain.”
5:03 “CPESN is all about how you can be a one-location pharmacy in rural Kansas but contract with 3500 other pharmacies to have a common product and a common set of performance metrics.”
8:23 “What is a value proposition [in 2022] is to use that dispensing event and the trust and the access and the frequency of our interaction as a very qualified health care unit with very qualified underutilized healthcare providers as a way of engaging a patient differently.”

This week's episode focuses on using your story to reach your target audience as Anthony Pacheco, president at P1311, discusses how to transform it into an exceptional but relatable message.
What You’ll Learn From This Episode:
1:17 Anthony’s pursuit of more affordable, higher-quality healthcare.4:03 How to make your brand stand out while also being very relatable.15:36 How they are bringing in a diverse clientele.17:42 How COVID has altered everything.20:09 Challenges and opportunities in the healthcare industry.Quotes:
2:23 “Just understanding that healthcare is very negotiable. A lot of times, what we don’t realize is that you can get a better quality of care for a lower cost. So, that’s kind of what brought me into this industry.”
2:41 “Most people think, you know, the rest of our lives, if you pay more money for something, you kind of have this reasonable expectation that it’s better quality. That’s not the case in medicine.”
14:35 “Every client is different, but if you show a strategy of five-year projections versus what can I do for you today, you have a better chance of winning that broker of record, right on the spot and developing with that client an understanding of their culture.”

This week's episode features Kelly Fristoe, the newly elected president of the National Association of Health Underwriters, who discusses recent developments and important changes they're implementing to better serve their members in this rapidly evolving industry.
What You’ll Learn From This Episode:
1:28 Kelly’s journey to becoming NIHU’s president.4:52 The primary reasons for changing the name of NIHU.7:59 Crafting NIHU’s objectives to evolving customer needs.9:14 Educating and preparing members about mergers and acquisitions.11:50 Changing member compensation from commission-based to fee-based agent.15:31 How they are assisting members with employer market issues.17:27 Bringing technology to NIHU’s members to enhance their business.18:11 Major health policy goal.18:45 The significance of organizational changes within NIHU.Quotes:
8:36 “Our customers’ expectations are changing. They want us now to help them solve the high cost of health care.”
10:26 “If we can help our members be better equipped and know what to expect, and have a toolkit, so to speak, on how to go about doing this and doing it right, that, I think, will create a better situation for our members and we’ll become more valuable to them.”
12:42 “If I change from a commission-based agent to a fee-based, then when I’m sitting at their negotiating table, along with them, there’s no question in their mind who I’m representing. The recommendation that I’m going to make is in their best interest.”